{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T01:27:26Z","timestamp":1775698046647,"version":"3.50.1"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>Our primary objectives were to (1) determine the rate of requiring conversion to arthroplasty after open reduction internal fixation (ORIF) of geriatric distal femur fractures and (2) compare 10-year reoperation rates after ORIF versus primary arthroplasty for geriatric distal femur fractures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Propensity-matched retrospective cohort study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>All centers participating in the California Office of Statewide Health Planning and Development (OSHPD) database.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients\/Participants:<\/jats:title>\n            <jats:p>All patients 65 years of age or older who underwent operative management of a distal femur fracture between 2000 and 2017.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>ORIF, total knee arthroplasty (TKA), or distal femur replacement (DFR).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main outcome measurements:<\/jats:title>\n            <jats:p>Reoperation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>A total of 16,784 patients with geriatric distal femur fracture were identified, of which 16,343 (97.4%) underwent ORIF. The cumulative incidence of conversion to arthroplasty within 10 years of ORIF was found to be 3.5%, with young age and female sex identified as risk factors for conversion. There was no significant difference in 10-year reoperation-free survival rate between propensity-matched patients undergoing ORIF versus primary arthroplasty (94.5% vs. 96.2%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.659). There were no differences in short-term complication or readmission rates between matched treatment cohorts, but arthroplasty was associated with a higher rate of wound infection within 90 days (2.0% vs. 0.2%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.011).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The 10-year cumulative incidence of conversion to arthroplasty after ORIF was found to be low. There was no significant difference in long-term reoperation-free survival rates between patients undergoing ORIF versus primary arthroplasty. Primary arthroplasty was associated with significantly higher rates of acute wound or joint infection.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000002535","type":"journal-article","created":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T18:27:15Z","timestamp":1675362435000},"page":"249-249","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Geriatric Distal Femur Fractures: Equivalent Long-Term Reoperation Rates Between Fixation and Primary Arthroplasty"],"prefix":"10.1097","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6949-7401","authenticated-orcid":false,"given":"Brendan Y.","family":"Shi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Upfill-Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dane J.","family":"Brodke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra I.","family":"Stavrakis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelson F.","family":"SooHoo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/S0020-1383(00)80034-0","article-title":"The epidemiology of fractures of the distal femur","volume":"31","author":"Martinet","year":"2000","journal-title":"Injury"},{"key":"R2-20250614","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1007\/s11999-010-1530-2","article-title":"Mortality after distal femur fractures in elderly patients","volume":"469","author":"Streubel","year":"2011","journal-title":"Clin Orthop Relat Res."},{"key":"R3-20250614","doi-asserted-by":"crossref","first-page":"e64","DOI":"10.1097\/BOT.0000000000001332","article-title":"Nail Plate combination technique for native and periprosthetic distal femur fractures","volume":"33","author":"Liporace","year":"2019","journal-title":"J Orthop Trauma."},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.otsr.2012.10.014","article-title":"Distal femur fractures. 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